Objectives: To evaluate the diagnostic yield of magnetic resonance (MR) imaging of adnexal masses compared versus histopathological findings of the excised specimen.
Patients & Methods: The study included 107 female patients presenting with symptoms suggestive of the presence of an adnexal mass. All patients had full history taking, clinical examination including abdominal and pelvic examination and then underwent abdomino-pelvic ultrasonographic examination. Patients with clinically suspect and ultrasonographically detected complex adnexal masses underwent contrast-enhanced MR imaging for preoperative assessment. All patients gave a venous blood sample for estimation of serum CA-125 level.
Results: Histopathological examination of excised specimens detected 51 benign lesions (47.7%) and 56 malignant lesions (52.3%). Mean total serum CA 125 level was 129.4±144.9; range: 10-532 U/ml and was ≤30 U/ml in 37 samples and >30 U/ml in 70 samples. Preoperative estimation of serum CA 125 sensitivity 87.5%, specificity 58.8%, positive predictive value (PPV) 70%, negative predictive value (NPV) 81.1% and accuracy rate of 73.8% for differentiation between benign and malignant adnexal masses. Preoperative MRI showed 8 false-positive results and 4 false-negative diagnoses and a sensitivity 92.9%, specificity 84.3%, PPV 86.7%, NPV 91.5% and accuracy 88.8% for differentiation between benign and malignant adnexal masses. Comparison of test validity characters of both CA 125 and MRI for differentiation between malignant and benign lesions showed significant difference (p |
